Discourse Analysis of Nurse-Patient Communication in a Hospital Setting

Abstract

This ethnographic study examined the symmetry (active listening)/asymmetry (dominance) of nurse-patient communication. A convenience sample of 20 gendered nurse-patient pairs from two community hospitals participated. Eleven discourse modes emerged from taped conversations between nurses and patients. In many nurse-patient interactions, nurses demonstrated symmetry; however, symmetry and asymmetry changed throughout the conversation. Nurses often missed cues that patients needed someone to listen to their concerns. Staff development implications include teaching strategies that increase symmetrical nurse-patient communication.

Nursing the patient with complex communication needs: time as a barrier and a facilitator to successful communication in hospital

“…Despite time limitations experienced by nurses, there is some evidence to suggest that nurses (a) implement a range of time management strategies in response to this, including the routinization and prioritization of tasks (Waterworth 2003), (b) are adept at adjusting their interactions to suit the available time, and (c) are able to manage their workload while communicating with patients in the time available (Barrere 2007). In a discourse analysis of interactions between patients and nurses in hospital, Barrere (2007) identified that hospital nurses communicate with patients in brief exchanges around the daily tasks of nursing. Such interactions are effective and can help establish positive nurse–patient interactions (Hagerty & Patusky 2003).…”

A communication intervention for nursing staff in chronic care

“…Although previous research suggests that communication skills training does not change practice in clinical areas (McCabe 2004, Barrere 2007, this study showed that nursing staff became aware of the importance of their interactions and actively redirected their conversations to become solution-focused and problem-free. Participating nurses realized the importance of effective communication as a fundamental component in delivering patient-focused care (D'Wynter 2007).…”

“…Infrequent and low-quality nurse-patient conversations are often attributed to nurses who do not have enough time to talk with patients (Dijkstra et al 2002). In addition, most interpersonal interactions between nurses and patients are treatment-or care-related (VM Boscart, unpublished MScN thesis, University of Ghent, Ghent, Belgium, Barrere 2007) and of a 'controlling' nature (Roth et al 2002), thereby inhibiting patient responses (Jones 2003, Williams et al 2003. Consequently, nurses mainly instruct and explain care to patients (VM Boscart, unpublished MScN thesis, University of Ghent, Ghent, Belgium) and are primarily concerned with completing care-giving tasks (Roth et al 2002, McGilton et al 2006.…”

Communication skills intervention: promoting effective communication between nurses and mechanically ventilated patients

“…It is in this regard that continuous training for all nurses on communication skills should be regular and mandatory for ICU nurses. A qualitative study by [21] emphasised the importance of teaching nurses, including nursing students, about communication skills such as active listening in the ICU. In support of this study, Happ [5] advocates that ICU nurses should be educated on nurse-patient communication.…”